Spotlight on PTAC: Strengthening the Data Foundation Needed for True Patient Empowerment
A National Focus on Patient and Data Empowerment The Physician-Focused Payment Model Technical Advisory Committee (PTAC) centered the agenda of its recent public meeting on a unifying theme: how data and health IT can transparently empower consumers and better support providers. PTAC’s role as an advisory body to HHS positions it uniquely to surface the structural challenges preventing patients from fully benefiting from digital tools, coordinated […]
CMS Is Pushing the Interoperability Envelope
By Mark Scrimshire, Chief Interoperability Officer, Onyx CMS hosted a special Health Tech Ecosystem Connectathon last week in Washington, DC — a one-day event that brought together nearly 300 participants from across payers, providers, vendors, federal agencies, and standards groups. The size and composition of the crowd made one thing clear: CMS isn’t just regulating interoperability. They are accelerating the ecosystem needed to make it […]
CMS-0057 Readiness: Challenges We’re Seeing and How Health Plans Can Move Forward
By Mark Scrimshire, Chief Interoperability & Security Officer, Onyx Health; Co-Chair, HL7 Financial Management Work Group; active contributor to WEDI The reality today By January 1, 2027, health plans are expected to have APIs live across Patient Access, Provider Access, Payer-to-Payer, and electronic Prior Authorization (ePA). Earlier this year, WEDI’s baseline survey found that 43 […]
A Day in the Life of CMS-0057: What It Means for Members, Providers, and Health Plans
CMS-0057, the Interoperability and Prior Authorization Final Rule, introduces four APIs that will shape how health data moves across the ecosystem: Payer-to-Payer Data Exchange – At the member’s request, securely transfer up to 5 years of their data when they switch plans. Provider Access – Give in-network providers access to a member’s data. Patient Access […]
Practical Approaches to CMS-0057 Compliance: Starting Strong and Staying on Track
The January 2027 CMS-0057 deadline is fast approaching. Some health plans are deep into execution, others are running pilots, and many haven’t yet made key decisions. No matter where you are, one thing is certain: the runway is shrinking, and the stakes are high. At Onyx, we’ve already taken customers live on CMS-aligned APIs and […]
Inside the Onyx CMS-0057 Playbooks
From Mandate to Measurable Value The Interoperability and Prior Authorization Final Rule CMS-0057 is reshaping how payers, providers, and patients exchange health data. It builds on CMS-9115 with expanded use cases, bi-directional APIs, and higher expectations across four tracks: Payer-to-Payer, Provider Access, Patient Access, and electronic Prior Authorization (ePA). Most provisions must be live by […]
Better Data = Better Care
We’re All In. A CMS-Aligned Network Yesterday’s announcement from The White House, U.S. Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services is a clear call to action: build health tech that actually works for the people who use it. At Onyx, we’re all in, guided by our purpose of […]
Onyx Health at the CMS July 2025 Connectathon: Demonstrating Real-World Readiness for CMS-0057
This week CMS held its sixth Connectathon, a three-day virtual event with 1,500 registered attendees. The Onyx team was there demonstrating OnyxOS and the capabilities that enable payers and providers to support the requirements of the CMS Prior Authorization regulation (CMS-0057).
Thoughts on CMS’ Moves to Modernize the Nation’s Digital Health Ecosystem
John Moore III published a post on LinkedIn where he commented on CMS’s moves to modernize the digital health ecosystem. You can find the post here: https://www.linkedin.com/posts/johnmoore3_cms-is-working-to-advance-health-technology-activity-7336779570106310656-N7VE/?utm_source=share&utm_medium=member_desktop&rcm=ACoAAAABGJoB1Za9PMjaa4O61h0nEu4nUfoq4p8 I wanted to comment on his post, but LinkedIn limits the size of a response, hence posting my response here. National Directory I am in complete agreement that […]
Who is Impacted by the Prior Authorization Rule?
Learn who is impacted by the CMS Prior Authorization Rule (CMS-0057)